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Purro Birik - (Healthy Spirit)
4.2 The Current Policy
Context
The project brief
identifies four documents are:
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policy documents as the
context for completing the project. The four Ways Forward, The National
Consultancy Report on Aboriginal and Torres Strait Islander Mental Health
(Swan and Raphael 1995);
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Achieving Improved
Aboriginal Health Outcomes: An Approach to Reform (Victorian Department of
Human Services and Victorian Aboriginal Community Controlled Health Organisation, 1996);
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Agreement on Aboriginal and Torres Strait Islander Health (Victorian Minister for Health, Commonwealth
Minister of State for Health and Family Services, Aboriginal and Torres
Strait Islander Commission, and Victorian Aboriginal Community Controlled
Health Organisation 1996); and
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Victoria's Mental Health
Service Framework for Service Delivery (Victorian Mental Health Branch 1994)
Ways Forward, The National
Consultancy Report on Aboriginal and Torres Strait Islander Mental Health
written by Pat Swan and Beverley Raphael in 1995, has laid much of the
foundation for the discussion that has occurred through the Purro Birik
consultations.
Endorsed by the National
Aboriginal Community Controlled Organisation (NACCHO), the report outlines
the following guiding principles.
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The Aboriginal concept of
health is holistic and encompasses mental, physical, social, cultural and
spiritual health.
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Self-determination is
central.
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Culturally valid
understanding must shape the provision of services.
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Experiences of trauma and
loss are major factors contributing to impairment of health and wellbeing.
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Human rights of
Aboriginal people must be recognised and respected.
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Racism, stigma,
environmental adversity and social disadvantage have a negative ongoing
impact on health and wellbeing.
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Family and kinship are
central.
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There is no single
Aboriginal and Torres Strait Islander culture or group.
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Aboriginal people have
great strengths.
Achieving Improved
Aboriginal Health Outcomes: An Approach to Reform is an agreement signed in
August 1996 between the Secretary, Victorian Department of Human Services;
the Director, Public Health, Victorian Department of Human Services; and the
Chairperson and Deputy Chairperson of VACCHO.
The document sets out a
reform strategy based on improved planning processes which recognise the
fundamental importance of community control, and cooperation between State
and Commonwealth Governments and VACCHO (as the peak organisation for
Victorian Aboriginal community controlled organisations).
The agreement supports the
provision of a broad range of preventative and primary care health services
through a Statewide network of Aboriginal community controlled agencies
which have adequate resources, capacity and infrastructure to deliver these
services. The agreement also recognises the importance of effective working
partnerships between Aboriginal and mainstream services on the local
community level to enhance the response from mainstream services to
Aboriginal people.
The Agreement on Aboriginal
and Torres Strait Islander Health between the Victorian Minister for Health,
the Commonwealth Minister for Health and Family Services, ATSIC and VACCHO
(signed in October 1996) aims to improve coordination of local and regional
planning by Commonwealth and State Government and Aboriginal community
controlled organisations.
The agreement outlines a
commitment to improving access, quality and cultural sensitivity of
mainstream services by establishing appropriate planning partnerships and
training programs; establishing appropriate data collection protocols; and
specifying the roles and responsibilities of the partners within the
agreement.
The agreement clarifies
that Aboriginal community control is the culturally valid process for
delivering Aboriginal specific health services, and that it is appropriate
for community controlled organisations to retain control over the design and
delivery of the services they are funded to provide (in light of agreed
outcomes).
The role of VACCHO in
service planning and development is set out in section 4.4 of the agreement.
This section refers to VACCHO:
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establishing community
principles, values and processes for planning and priority setting;
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jointly participating in
planning processes with Commonwealth and State Government departments;
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leading and monitoring policy development on behalf of community controlled organisations;
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promoting links between community controlled organisations;
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providing information on
health programs and policies to community controlled organisations; and
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advising on and undertaking
research, including the development and management of data collection within community controlled
organisations.
Victoria's
Mental Health Service Framework for Service Delivery released in March 1994
was the blueprint for the current organisation of public mental health
services in Victoria. The document provided the direction for the shift from
an institution-based mental health service system to one that emphasises
community-based service delivery.
The public mental health
system in 1999 is based on a system of integrated area networks of community
and inpatient services. There are 21 adult area mental health services, 17
aged persons mental health services, and 13 child and adolescent mental
health services, all of which are arranged into catchments that cover the
entire state. In addition, 76 psychiatric disability support services
provide day programs, residential rehabilitation, planned respite,
home-based outreach support, and mutual support and self-help programs.
There are a number of
statewide specialist services provided, which include forensic psychiatry,
neuropsychiatry, brain trauma services, services for people with severe
personality disorders, services for people who have eating disorders, and
mother/baby services.
The Framework document
defines processes for access to mental health services; priority for serious
mental illness; treatment close to home in least restrictive environments;
and the requirement for minimum interference with the rights, dignity and
self-respect of consumers.
These four documents
essentially provide the starting point for the Purro Birik project, and need
to be understood to ensure the project builds on the existing agreements
which have been established, and takes the most appropriate directions on
service development issues.
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